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Individual Health Insurance | Group Health | Term Life | Dental | Short Term  
 
Application & Enrollment for Washington Health Plans
To apply for any of the plans shown, see the instructions below.

Lifewise of Washington

Regence Blue Shield

KPS Health Plans of Washington

Assurant Insurance

You may also simply contact our office at  1-866-527-1910 (PST).

 

 
Lifewise of Washington
Apply Online

You may apply directly online by following the link above to our safe and secure online application process.   We recommend this online process, it is safe, fast and secure and will enable the completion of your application in a much shorter amount of time. 

 

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Regence Blue Shield of Washington

 

Regence Blue Shield Individual & Family Health Application

Standard Health Questionnaire

You must complete a  Standard Health Questionnaire for each person applying for coverage unless you meet one of the exclusionary  requirements as outlined on the application.    
 

Regence Blue Shield of Washington

 

Please do not send a rate payment with your application. You will receive a statement from Regence BlueShield upon acceptance of your application.

The mailing address to send your completed application directly the insurance company is shown on the application after you print it out.   

Please note: All COMPLETED enrollment materials should postmarked prior to the 20th of the of the month for which coverage to become effective for.

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KPS Health Plans of Washington KPS Health Plans
KPS Health Plan Application

To print an application simply click on the link above and then print.
You will need to complete a Standard Health Questionnaire for each person applying for coverage unless you meet one of the exclusionary  requirements as outlined on the application. 
 

The mailing address to send your completed application directly the insurance company is shown on the application after you print it out.   
 

Please note: All COMPLETED enrollment materials should postmarked prior to the 20th of the of the month for which coverage to become effective for.

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Assurant Health Insurance
Apply Online Now!

You may apply directly securely online by clicking on the link above, or print out and complete the enrollment forms provided below.  We recommend the online process, it is safe, secure, accurate and allows the completion of your application much quicker than by mail.

Assurant Application

Standard Health Questionnaire

To apply  for coverage please print out one application by clicking on the following line.  For each applicant applying a separate health questionnaire must be completed, which may printed out from the following link; Standard Health Questionnaire.

If you are applying for a HSA with Assurant this supplement application should be completed and returned along with the Application and Health Questionnaires'.

HSA Supplement Application

Assurant Health an application must be completed along with a Standard Health Questionnaire for each person applying must be completed and accompany the application.  The application should be mailed directly to our General Agents mailing address of; 

Westcoast Agencies Inc
PO Box 2168
Battle Ground, WA  98604 

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For questions or help with any of these plans please Contact Us.